Underuse of beneficial drug therapy by seniors has been associated with increased morbidity, mortality, and reduced quality of life. Efforts to address this issue in the elderly population must focus on educating health care providers, improving the adherence to prescribed drug regimens by older patients, and reducing the financial barriers to access to essential medications. The fewer-the-better approach to drug therapy in the elderly does not work when drugs with proven efficacy in elderly patients are available. It is time to evolve to a more sophisticated model for achieving optimal drug therapy in the older population that emphasizes a more balanced and rational approach to prescribing.